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Thursday, August 22, 2013

Hey, everyone! Given that as actors we're constantly in a battle between making money and being artistic, I thought I'd write a series of blogs about different ways you can use your acting skills to make money. And I oughta know - I’ve done a crap ton of unique and crazy work all in the name of being a working actor.

Part 1- Standardized Patient for Medical Schools

Ever see the episode of "Seinfeld" where Kramer signs on to be a "fake patient" at a local hospital? (clip from show) Would you believe that these jobs actually exist? Ok, so the TV show over-dramatizes the job, but every day in medical schools throughout the country, actors are being used as "standardized patients” - allowing medical students and resident MDs to practice/test their clinical skills in a safe and controlled environment. This past week alone, I spent 3 days playing 3 different cases, and it is a heck of a lot of fun.

The scenarios we do have to be kept under wraps, because most involve national testing for medical students to get to the next level. But I thought I could still give you a little taste of what we do, and what the programs are like.

The idea behind using standardized patients (SPs) is one of fairness - if students are expected to see a patient in a testing situation, they have to make sure each student gets an identical test. Given that no two actual patients are the same, medical schools hire actors and train them to give an identical, precise performance. So, all SP work starts with thorough training on a specified case. We learn the back story of the character (which can be up to 15 pages of content, sometimes more) as well as the general demeanor while in the scenario - should the patient be frightened? Frustrated? Edgy? Easygoing? What kinds of clues should we give in our performance to indicate that there is something deeper going on, something that the student should dig for?

Then we make sure we understand all of the medical jargon that might be thrown at us, and we learn the correct (and incorrect) ways to do physical exam maneuvers. For example, did you know that they teach students to listen to the heart in 4 keys areas, and to compare the lungs, listening at a minimum of 3 levels -- and this is called auscultating? Did you know that testing for eye movements (“follow my finger”) can be used to see if a patient has hyperthyroidism? (indicated by eyelids that are slow to respond when the eye moves -- who knew?) I know more medical terminology and practices than I ever thought possible. It’s pretty awesome to be on the inside track of this amazing profession.

Then comes the fun part - doing the actual scenarios. This is improv at its finest, because despite training on a case and knowing your character cold, you never know what kind of questions will be thrown at you. Just yesterday, I (as the character) told the student that I have two kids. Instead of them asking how old the kids were, the student asked me how old I was when I had my kids. (Say wha?? I was not prepared for that! I mean- c'mon, I majored in theater so I wouldn't have to do math on the fly.) But somehow I was able to stall the student while I did the math in my head. Other times, I haven’t responded so gracefully. One November several years ago, the student asked, “What costumes did your kids wear for Halloween?” I froze, then blurted out, "We don't celebrate holidays!” leading to a few seconds of awkward silence. (Yeah... not my finest moment.) But now I always try to guess what kind of small talk the doctor will do (“where do you live?” “what do you do for fun?”) and then come up with something appropriate for the character. The good news is that those little details can vary from SP to SP - not everything has to be strictly the same so there is some room for creativity.

Finally, the SP is charged with leaving feedback about the encounter. Sometimes, feedback is given to the student verbally, involving the SP telling the student how it felt to be their patient. But most of the time, the SP fills out a digital checklist at the end of the encounter, which notes the student’s success in the areas of history taking, physical exam and communication.

This is where it gets tricky - we wear “two hats” as an SP. On the one hand, we’re a patient with a full history, complete with thoughts, feelings and fears. On the other hand, we’re an educator, going through a mental checklist while answering questions to make sure the student has the opportunity to cover everything on the exam checklist. This means that both sides of the brain are working at once, and it can be easy to become overloaded or confused. Often, an SP will see 12-14 students in a given day in 15-30 minute encounters. At the beginning of the day it’s easy to remember which questions you’ve answered and which you haven’t. But at the end of the day, when you’ve answered the same batch of questions 12 times, you start to become a little fuzzy on which items this student asked and which they missed. So, a sharp mind and good memory are essential for the job.

One of the greatest things about SP for work actors is that it is very flexible. Much like temp work, once you are in the system they notify you when work comes up in your age range/type. If you’re available, you do the program. If not, they’ll ask again for the next program. Therefore, as an SP I can take on as much work as possible when not working on a film or theater project, and then take a break from SP work when I’m working elsewhere as an actor.

As an actor, SP work is fabulous training, particularly in the practice of “the illusion of the first time.” Recently, I had to see 14 students as a part of the Compass II 3rd Year exam. Each student needed to have the exact same portrayal, so each time there was a knock on the door, I had to reset for a brand new encounter, as though I’d never done it before. This is where my work on film sets comes in real handy. And for those of you who subscribe to the Stanislavski and/or Strasberg techniques, being an SP is a fabulous way to practice sensory work.

If you’re interested in doing this kind of work, your best bet is to contact the medical schools in your area and ask for the department that handles standardized or simulated patients (usually the department of medical education.) You can often find that information on the school’s website or you can just call the main switchboard. I did some basic research for NYC, LA and Chicago, and here are a few of the major medical schools. (Note- not all schools have their own program - they may share in a single SP program. For example, many NY/NJ/CT schools use Mount Sinai’s Morchand Center for their testing. Contact each school for more information...):

Here is a list of programs from the Association of Standardized Patient Educators (though, it does not appear to be complete. I happen to know that there is a robust program at UCSD Medical School in San Diego, but it is not listed.)

Added Bonus: (Because at The Actors’ Enterprise, we think you deserve bonuses every now and then!) As I was searching for the clip from Seinfeld, I came across some spoof videos about standardized patients. Now, granted, some of these might be more like inside jokes for folks already involved in med school or with SP work, but I thought they were worth sharing... Clip 1 / Clip 2 / Clip 3 / Clip 4. Enjoy!

What do you think? How many of you have done SP work, and what schools have you worked with? We’d love to hear about your experiences (especially the funny ones!)

Have a comment or question? Leave it by clicking below!

Erin Cronican's career as a professional actor and career coach has spanned the last 25 years in New York City, Los Angeles and San Diego. She has appeared in major feature films and on television, and has done national tours of plays and musicals. She has worked in the advertising & marketing departments of major corporations, film production companies, theater magazines, and non-profit acting organizations. To learn more, check out http://www.theactorsenterprise.org.

6
COMMENTS - Click to READ:

Anonymous
said...

Hi Erin! Thanks for sharing this. I have two questions: how often could one expect to work in this capacity? what are the peaks of activity throughout the calendar year? (I'd imagine vacation is downtime, but other than that...) Thanks! ~Mariana

Great questions, Mariana. Kind of like temp work, the more often you say yes to a program, the more often they call you in. Usually, when they call you in for one program you'll be called in for that exact program every time they do it, because you're already familiar with it. Usually those programs happen once a year. Where it becomes more lucrative work is when you work multiple programs in a year. I'm pretty much always working on a program.

Medical schools do have summer breaks, but many medical schools have summer programs to fill in the gaps. Even though it's currently summer, right now I'm working on two programs for Mount Sinai, which gives me work at least 1-2 days per week. I think the busiest time would be late winter/early spring, but usually during those times only one program is happening at a time.

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erin cronican: founder / coach

Erin Cronican is a professional actor (AEA/SAG-AFTRA) and has been coaching on the business of acting since 2007. She is a columnist for Backstage magazine and is the Managing Director of The Seeing Place Theater, a critically acclaimed indie theater in NYC.